|
<br />APPLICATION FOR PER1'IIT
<br />CITY OF ZEPIIYRlIILLS
<br />BUILDING DEPARTMENT
<br />
<br />~'
<br />I jl
<br />1/'
<br />
<br />1}11~!-s ~//L
<br />ADDRESS 7 -:r/ ~ 6/) < IP/V'
<br />Pt17~1Jif~ j..
<br />JOB LOCATION ~-# Lf:J-}}tH
<br />LEGAL DESCRIPTION: LOT(S) .;It ~
<br />PARCEL 1. D. It -3 ~,.. .-?..3~ ~ J -
<br />
<br />APPLICANT
<br />
<br />L//.
<br />
<br />Dd1 ;Z 'H } 1-2-5 PHONE .7 g_'3
<br />L~,AJ Eh':/Y'JY/.Y"
<br />CT
<br />
<br />? :&~ ff"'" --
<br />
<br />J 7t, /
<br />,
<br />
<br />7" .yJ
<br />
<br />OWNER
<br />
<br />LOT SIZE_~ AREA SQ.FT,
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />1l1.1~~
<br />J /, f/~
<br />
<br />Y I22/76 €..
<br />
<br />~p.?f7
<br />
<br />()/Jppd -
<br />
<br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
<br />
<br />_Sign/Temp,
<br />
<br />_Sign
<br />
<br />_t'-love
<br />
<br />_Demolish
<br />
<br />PROPOSED USE: _Single Family
<br />
<br />_f~ of Uni ts
<br />-t-swim. Pool
<br />
<br />_Restaurant & Health Department Approval
<br />
<br />_H/F
<br />
<br />,,_M/H
<br />
<br />_Commercial
<br />
<br />_Indust,
<br />
<br />Other
<br />
<br />BUILDING SIZE:
<br />
<br />x
<br />
<br />Square Fec t,
<br />
<br />Height
<br />
<br />RESIDENTIAL:
<br />COMMERCIAL :
<br />
<br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING Pl.ANS ,y. (1) SET ENERGY FORMS.**
<br />ATTACH (3) SETS OF BUILDING PLANS << (1) SET ENERGY FORr-1S. H
<br />**COPY OF CONTRACT REQUIRED,
<br />
<br />PERMITS REOUESTED
<br />
<br />i-BUILDING
<br />-i-ELECTRICAL
<br />_MECHANICAL
<br />
<br />$
<br />
<br />J7;
<br />
<br />;?L?bl_ ~ j1 Valuation of Total Construction
<br />AMP Service ~Florida Power Corp,
<br />
<br />Valuation of Mechanical Installation
<br />
<br />_W.R.E.C,
<br />
<br />$
<br />
<br />,.
<br />
<br />~PLUMBING GAS
<br />TYPE OF CONSTRUCTION: _Block
<br />
<br />ROOFING
<br />
<br />SPECIALTY
<br />
<br />_Frame _Steel
<br />
<br />Other
<br />
<br />FINISHED FLOOR ELEVATIONS: FT,
<br />
<br />******************************************
<br />
<br />BUILDER
<br />
<br />CONTRACTOR SECTIO~ )
<br />Company t7 tI3 73
<br />/? ~ ~ State Cert, or nr:r,ist. !I
<br />~A'~(7 c:r ,~ City License ner~ i:,Lratinn
<br />C ***********************,', {,{,* i,* {,{, ,', {", ':, ,', ,', ,'", {, ,', *
<br />
<br />~4~1 ~/ Company ;{(C~~.f.. ~~_A'" ?~~, GLJ
<br />State Cert, or J{('r.i s roO II
<br />City License Er:f',istration jl C' 72-
<br />******************************************
<br />
<br />Pt,t? 2- CL7,
<br />'1~IJ()
<br />It ~...,,~
<br />
<br />Signature
<br />
<br />ELECTRICIAN
<br />
<br />Si!!nature
<br />
<br />Signature
<br />
<br />
<br />Company
<br />State Cert, or Eq:ist. It
<br />City License J{et:istration
<br />******************************************
<br />
<br />I)h? ~~
<br />
<br />~2 __~~
<br />j~ ..:; ~ ..
<br />
<br />MECHANICAL
<br />
<br />OTHER
<br />
<br />7/7-
<br />
<br />Company
<br />State Cert. or R('~ist. #
<br />City License I\(~I~i.sL!'iltion If
<br />******************************************
<br />
<br />Signature
<br />
<br />Company
<br />State Cert, or J{enist. #
<br />City License I\cr:istration j~
<br />
<br />Signature
<br />
<br />APPLICATION APPROVED BY
<br />
<br />
<br />PERI-lIT OFFICER.
<br />
|